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| Fibrocystic Changes | ||
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Other terms used to describe:
• Chronic cystic mastitis
• Cystic mastitis
• Fibrocystic disease
• Mammary dysplasia
Definition of terms:
Chronic - Lasting a long period of time
Cystic - Pertaining to a closed sac with a definite wall that contains fluid, semi-
fluid or solid material
Dysplasia - Abnormal development of tissue
Hormones - Chemicals made by the body that affect the function of cells; the most common
female hormones are estrogen, progesterone and prolactin
Fibrocystic - Cystic formations, containing either fluid or solid material, that cause a
change in the breast that can be felt or seen on x-ray
Mammary - Referring to the breast
Mastitis - Inflammation (pain, warmth, redness) of the breast
Microscopic - Too small to be seen by the eye; only visible with a microscope
Fibrocystic changes, a term used by physicians and pathologists, describe a
number of non-cancerous conditions occurring in the breast. These conditions
are found in the breasts as lumps or masses which occur and change with the
menstrual cycle and may be accompanied by pain and tenderness. Previously, the
term "fibrocystic disease" was used to describe the process and was falsely
implicated as a risk factor for cancer. However, at least 50 percent of all
women have irregular feeling, lumpy breasts. Furthermore, studies have shown
that as many as 90 percent have microscopic, fibrocystic changes.
These changes are a normal response to the hormonal stimulation of the breast
tissue and do not represent a "disease" process . Thus, the term "fibrocystic
disease" is not an accurate description of the changes. Fibrocystic changes do
not increase the risk for cancer. The term is commonly applied to any change
that is not cancerous. Because there is no exact clinical definition, ask your
physician precisely what type of changes have been found in your breast tissue
if you receive the diagnosis of fibrocystic changes.
Breast lumpiness
The breasts are very complex glandular organs that consist of 15 to 20 lobes
that radiate from the nipples. These lobes further divide into 20 to 40 lobules
that contain 10 to 100 alveoli where the milk or fluid is produced in the
breast. This whole glandular structure is changing constantly because of the
stimulation of estrogen and progesterone hormones on the breast tissue. When
the stimulation begins after the menstrual period, the breasts respond by
beginning to fill with fluid. Each breast will produce and store between 15 to
30 ccs (3 to 6 teaspoons) of fluid in the ducts during the month. This causes a
feeling of lumpiness, especially right before a menstrual period. The hormonal
influence also causes extra layers of cells to be produced in the ducts. The
combination of the two causes an increase in the size of the breasts and
possibly tenderness or pain.
Some drugs routinely prescribed by a physician can cause some women to
experience lumpiness, fullness and tenderness in the breast tissues. This type
of lump feels very similar to those produced by hormonal changes in the body.
The changes are not harmful but the causes may confuse you or your physician.
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Examples are:
Blood pressure medications
Aldactone® (a diuretic)
Aldomet®
Heart medications
Digoxin®
Lanoxin® (digitalis)
Inderal®
Lopressor®
Tenormin®
Visken®
Antipsychotic/antinausea drugs
Compazine®
Ulcer medications
Tagamet®
When you check your breasts before your menstrual period, they will feel
different than at the end of your period. Therefore, it is very important to
examine your breasts on a regular basis at the same time of the month; the best
time is at the end of the cycle. The increase in cells and fluid in the breast
will often cause them to feel lumpy. If you find a lump in a breast, feel the
opposite breast in the same area for a similar change. If one is found, you
probably have discovered a normal hormonal change. It is safe to wait and go
through a menstrual period and re-check the same area. If the area is smaller
or softer at your second self-exam, then it has been stimulated by hormonal
changes that are normal. If the lump has not become softer or smaller, a
physician will need to evaluate the area. Every woman has a normal pattern of
lumpiness and bumpiness in her breasts tissue. Only through regular self-exams
can a woman get to know this pattern of lumpiness in her own breasts. A
physician examining the breasts once a year will not be able to learn the
individual patterns of breast lumpiness.
Breast pain
The term "mastalgia" ("mast" is Latin for breast, "algia" for pain) is a term
used by many physicians. Most women experience increased tenderness in their
breasts before their period. Again, this is from fluid accumulation in the
breasts. Some women experience greater pain prior to the beginning of the
period. This pain usually decreases at the end of the period. This type of pain
is associated with fluid and the stimulation of the breast tissues by the
hormones estrogen and progesterone. If pain is not associated with the
menstrual cycle or hormonal menopausal medication, consult your physician.
Some women report less pain when caffeine is decreased or eliminated from their
diets. Caffeine-containing substances include coffee, tea, cola and chocolate.
Other women are not affected by eliminating caffeine from their diets. Reducing
sodium intake has also been effective in reducing pain in some women. Some
physicians have found benefits in using vitamin E and other vitamin supplements
to reduce pain. Herbal supplements, such as Ginseng or Dong quai may actually
increase breast tenderness, pain and/or discharge. Contact your physician for
recommendations.
Breast discharge
Some women experience a clear to milky color discharge from their breasts right
before the start of their monthly cycle or at the beginning of their menstrual
period. This type of discharge is not unusual. It may also be noticed after
sexual stimulation or when women begin taking estrogen supplements. The
medications listed above have also caused some women to experience breast
discharge. An occasional small amount of discharge from both breasts is not
abnormal. However, if this discharge continues throughout the month, comes from
only one breast, or has any evidence of blood, contact your physician.
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